Several years ago, Sue Crane stood at the top landing of her home's second-floor staircase.

As she started to descend the old wood steps, a light from a room caught her eye, so Crane, an older adult, shifted to go shut it off.

"I turned and fell all the way down the steps, head first," she said.

Luckily, she wasn't badly hurt, but the memory of the incident still lingers.

"From that day, I think about going down stairs every day," said Crane, who lives in Red Hook, where she's the town supervisor. "That's the kind of home accident that can be the end of you. I was just fortunate."

Indeed. According to the Centers for Disease Control, falls are the leading cause of fatal and non-fatal injuries among older adults, with more than 2.3 million older adults treated in emergency departments for nonfatal injuries from falls in 2010, more than 662,000 of whom were hospitalized.

The National Council on Aging reports along with pain, suffering and high rehabilitation costs, falls affect seniors' quality of life, whether or not an injury was incurred. Often, falls leave people feeling afraid of doing so again, with some people then limiting their activities, contributing to physical decline, depression, social isolation and feelings of helplessness.

Beth O'Keefe, a registered nurse care coordinator with Visiting Nurse Service of New York's VNSNY CHOICE, works in the Fishkill/Beacon area and said falls can be especially difficult on seniors.

In addition to enduring physical trauma, falls often shake the confidence of seniors, said O'Keefe, leaving many uncertain as to whether they can take care of themselves. And, because aging causes declines in vision, muscle strength and balance, along with medical issues, seniors are especially at risk for falls.

"You want to be able to be as independent as is possible for you, based on your health and physical condition, in as safe a way as possible," O'Keefe said.

In the home, she said, do a safety assessment, checking issues that could make a person vulnerable to a fall.

Begin with lighting, the top issue in preventing falls.

Be sure all hallways, bedrooms and other areas are adequately lit, as seniors' vision often is compromised.

Keep all pathways clear of tripping and slipping hazards by putting away mislaid objects and wiping up spills.

Install banisters and grab bars, especially on staircases and in bathrooms, the latter of which also should have non-slip mats and a shower chair. Keep the bed low to the ground to avoid struggles getting in and out of it, and keep a walker or cane in easy reach, on each floor of the house.

"A lot of people have scatter rugs around the house," O'Keefe said. "They look very nice, but they're a major tripping hazard."

Outside the home, she said, stick with well-lit areas and wear shoes that are properly secured and fitted with a non-slip sole.

Use a cane or walker for added balance and watch out for irregular sidewalks and pavements, as well as curb steps and changing ground levels.

An even walkway to a home’s entryway with wide steps and railings provides easier access for older adults.(Photo: Karen Maserjian Shan/For the Poughkeepsie Journal)

"What you want is for people to be able to stay as engaged as possible, whatever level they're at," said O'Keefe, as the less active people are, the more they tend to retreat.

It's important, then, that older adults use their ambulatory aid, take their medications and keep their doctor's appointments.

"We want them to be able to stay in their homes, where they want to be," O'Keefe said.

Dr. Jodi Friedman, who specializes in geriatric medicine and is medical director of the Center for Healthy Aging at Northern Dutchess Hospital in Rhinebeck, recently ran a workshop on fall prevention and balance at the center, with more such programs in the offing.

Seniors fall for a number of reasons, she said, that often stem from gait difficulties due to decreasing balance, pain issues like those associated with arthritis, and side effects from medications, such as dizziness and vision problems.

Worse, declining bone mass can contribute to fractures resulting from a fall, making recovery difficult.

That's especially true in the winter, when it's hard for many seniors to get out, even for a walk.

Additionally, Friedman suggested that seniors have their medications reviewed for troublesome side effects, possibly adjusting dosages per their doctors' recommendation. They should have their Vitamin D level checked, as low levels have been associated with falls and osteoporosis, or weak bones. They should also have their eyes examined for vision problems.

Friedman said while a serious injury from a fall can be devastating for a senior, bumps and bruises also are an issue as they can cause people to pull back, restricting their activities and, in turn, weakening their physical strength, while reducing their quality of life and independence.

"If you have a fear of falling, then you're going to limit your activity, then you're at a higher risk of falling," she said.

Crane said safety in the home relates to aging in place programs, in which communities provide housing, transportation and other senior support services. The philosophy resulted in the construction of 96 homes for seniors in Red Hook.

The issue has hit home, so to speak, for Crane.

"It's very important to me because I have a house that has flights of stairs," she said. "I have had to think about — as I'm less nimble — what are the trip-ups that might cause me to fall?"

Crane, who took care of her aging mother years ago, doesn't have throw rugs, uses banisters on staircases and is sure to wipe up floor spills to prevent accidental slips.

"If you have ceramic floors, you really have to be careful, because they're very unforgiving," she said.

Likewise, grab bars in the bathroom are helpful, she said, as are night lights, especially for tripping hazards, like a shoe left in a hallway.

And for those who have pets, watch that your dog or cat doesn't get underfoot.

"It's the little things that when we're young, they're not a big deal," Crane said.

• Visit the Center for Healthy Aging at Northern Dutchess Hospital for ongoing balance and exercise programs for seniors: www.health-quest.org/CHA

Myths of falls for older adults

Falling happens to other people, not to me.

Reality: One in three older adults — about 12 million — falls every year in the U.S.

Falling is normal as you get older.

Reality: Falling is not a normal part of aging. Strength and balance exercises, medication management, vision checks and establishing a safe living environment help prevent falls.

If I limit my activity, I won't fall.

Reality: Physical activities help people stay independent, as it boosts strength and range of motion.

As long as I stay at home, I can avoid falling.

Reality: Over half of all falls take place at home. Fix simple but serious hazards such as clutter, throw rugs and poor lighting. Install grab bars and handrails on stairs, use non-slip paint on outdoor steps.

Muscle strength and flexibility can't be regained.

Reality: Exercise can partially restore strength and flexibility.

Taking medication doesn't increase my risk of falling.

Reality: Medications can make people dizzy or sleepy, putting them at risk for a fall.

I don't need to get my vision checked every year.

Reality: People with vision problems are more than twice as likely to fall as those without visual impairment.

Using a walker or cane will make me more dependent.

Reality: Walking aids help many older adults maintain or improve their mobility.

I don't need to talk to others about my fear of falling. I don't want to alarm them and I want to keep my independence.

Reality: Fall prevention is a team effort. Bring it up with your doctor, family and anyone else who is in a position to help.

I don't need to talk to an older family member/friend about my concern of his/her risk of falling. It will hurt his/her feelings and it's none of my business.

Reality: Let the person know about your concerns and offer support, such as removing hazards in the home, finding a fall-prevention program in the community or setting up a vision exam.